NEW YORK — The death of Hall-of-Fame baseball player Tony Gwynn from mouth cancer has renewed calls to end the use of chewing tobacco from its traditional place in the game.

Gwynn, 54, died June 16 after two surgeries to remove malignant growths inside his right cheek, where the former San Diego Padre said he chewed tobacco while he played. He was one of more than 40,000 people diagnosed with oral cancer yearly in the United States, according to the Oral Cancer Foundation.

Only a little more than half of these patients will be alive in five years, U.S. health officials say, mostly because oral cancers are usually discovered only after they've spread to another location, such as the lymph nodes in the neck. It's estimated that at least 75 percent of those diagnosed with oral cancer at 50 have been tobacco users.

"We've decreased the rate of smoking tobacco but not the rates of chewing tobacco." said Mark Agulnik, an oncologist at Northwestern University's Robert H. Lurie Comprehensive Cancer Center in Chicago. "Cancers that form are just as aggressive in the smokeless tobacco as in smoked tobacco."

Joe Garagiola, a former major-league catcher and broadcaster who for decades has been an advocate against the use of smokeless tobacco, said the strongest steps should be taken to rid the game of the product.

"Smokeless is not harmless," Garagiola said.

While baseball prohibits the use of chewing tobacco within the view of fans, Garagiola wants a complete ban of what he calls "spit tobacco."

"The player's association has to vote on it," he said in a telephone interview. "I just wish that they would take a more serious look at it and don't wait for good people to die, good guys like Tony Gwynn. That's a big loss for baseball."

Gwynn, who spent his entire two-decade career with the San Diego Padres team, was an eight-time National League batting champion and was named to the All-Star team 15 times. He was elected to the National Baseball Hall of Fame in 2007, his first year of eligibility, with 97.6 percent of the vote. Gwynn was on leave from his position as head baseball coach of San Diego State University, where he starred as a two-sport athlete, when he died.

Gregory Connolly, a professor at the Harvard School of Public Health in Boston who has worked to get chewing tobacco out of baseball for about 30 years, says Gwynn's loss may be a harbinger of future disease.

"Even though we see few reports of deaths now, the form of chewing tobacco that he took up is relatively recent in our country," Connolly said. Use of chewing tobacco began to increase among younger people in the 1980s. He said use of smokeless tobacco has increased in the past several years.

Page 2 of 2 - As a result, the number of people in their 50s, like Gwynn, being diagnosed with the disease later in life is on the rise, according to Connolly. "We do know your risk factor greatly increases with age," he said. "It's devastating. The 5-year mortality rate is 50 percent, and if you don't die, you're left totally disfigured."

Connolly said he would like the federal government to "come up to the plate" in helping fight the use of smokeless tobacco. He urged that chewing tobacco be regulated similarly to other forms of the drug, with aggressive warning labels and a ban on flavored forms.

By regulating cigarettes and not smokeless tobacco, it "just transfers cancer from the lung to the mouth, and people walk around crippled from those deformities," he said.

The U.S. National Institutes of Health has called smokeless tobacco one of the fastest growing detrimental health habits in North America as "sports figures promote the product in an attempt to erase the old, unsanitary image of the habit and replace it with a macho image."

Athletes, military personnel and people who find it difficult to smoke in their businesses tend to switch to smokeless tobacco, said Pamela Clark, a research professor at the department of behavioral and community health at the University of Maryland College Park. Clark is doing research work for the Food and Drug Administration on the use of smokeless tobacco. She also said men and people who live in rural areas are more likely to chew tobacco.

Smokeless tobacco composes about 10 percent of sales for Altria Group Inc., the largest seller of tobacco in the United States. The company saw a 5 percent sales rise in 2013, according to data compiled by Bloomberg. Altria Group representatives didn't return calls or emails for comment.